AB0536 RELATIONSHIP OF EXERTIONAL ACTIVITY AND MENTAL WELLBEING IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: S. Beider, T. Witte, D. Ernst
Journal: Annals of the Rheumatic Diseases (2022)

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variety of clinical manifestations [1] and has a profound effect on physical health [2]. Anxiety and depression are common symptoms of SLE which can have a significant impact on the quality of life [3]. Objectives To study whether or not the physical state of health relates to the extent of anxiety and depression in SLE patients. Methods The Physical Component Summary Score (PCS) was determined using the 36-Item Short Form Survey (SF-36) in a cohort of 146 SLE patients consecutively visiting our outpatient clinic. Two groups were compared: one group with low PCS&lt;50 % (LPCS) and the comparison group with high PCS ≥50 % (HPCS). Patients with SLE who visited our Rheumatology clinic between March 2019 and December 2020 as part of a monocentric cross-sectional study completed additional standardized questionnaires: Hospital Anxiety and Depression Scale (HADS), Beck’s Depression Inventory (BDI II), Multidimensional Assessment of Fatigue (MAF), Functional questionnaire Hanover (FFbH) and the international questionnaire on physical activity in short form (IPAQ-SF). The data was analyzed with SPSS 27 (IBM, Armonk, NY, USA). The tests include bivariate and partial correlations. Significance tests were performed using non-parametric tests. Results In total, 146 patients participated in the study. 14.4 % (n = 21) were male and the mean age was 48.6 ± 12.2 years. The mean state of physical health according to SF36 was 54.9 % ± 25.6 % in the examined cohort. There were 62 (42.5 %) patients with LPCS, of average age 50.4 ± 10.3 years and 84 (57.5 %) with HPCS, of average age 47.2 ± 13.3 years. The majority of patients in both groups were female (55/7, 88.7 % and 70/14, 83.3 %). A SLEDAI score &gt; 2 was confirmed in 33.9 % (n = 21) of the patients with LPCS and in 25 % (n = 21) of patients with HPCS, the mean SLEDAI score did not significantly differ between LPCS and HPCS patients (2.4 versus 1.9, p = 0.261). Among patients with LPCS, 54.8 % (n = 34) presented low physical activity and 64.5 % reported functional impairment (FFbH &lt; 80). More than half of LPCS-patients (53.2 %, n = 33) showed a low Mental Health summary score (MCS &lt; 50 %) and over a third of them had moderate to severe depression (BDI II &gt; 19, 38.7 %, n = 24) and indicated pathological anxiety (HADS &gt; 10, 37.1 %, n = 23). Compared to the LPCS group, a smaller number of patients with HPCS had low physical activity (36.9 %, n = 31, p = 0.031) and the difference in mean weekly MET between the two groups was 2730 counts (p = 0.003). There was no impairment of functional capacity in patients with HPCS (FFbH mean Score 90.9 %, p &lt; 0.001). In contrast to the LPCS group, only 17.9 % (n = 15) of the patients with HPCS showed MCS &lt; 50 % (p &lt; 0.001). Completely free of depressive symptoms were 65.5 % (n = 55) of the patients with HPCS and only 4 patients (4.8 %) reported moderate to severe depression (p &lt; 0.001). Patients with LPCS reported fatigue (GFI &gt; 20) more often than patients with HPCS (98.4 % versus 54.8, p &lt; 0.001). Conclusion SLE patients with low physical health conditions have highly significant mental health impairment, particularly anxiety and depression. Physical functioning and limitations due to physical health should be considered and physical activity needs to be improved. Measurement of the PCS should be a routine tool in the overall assessment of the health conditions of SLE patients. References [1]Lisnevskaia, L., G. Murphy, and D. Isenberg, Systemic lupus erythematosus. Lancet, 2014. 384(9957): p. 1878-1888. [2]O’Dwyer, T., L. Durcan, and F. Wilson. Exercise and physical activity in systemic lupus erythematosus: A systematic review with meta-analyses. in Seminars in arthritis and rheumatism. 2017. Elsevier. [3]Figueiredo-Braga, M., et al., Depression and anxiety in systemic lupus erythematosus: the crosstalk between immunological, clinical, and psychosocial factors. Medicine, 2018. 97(28). Disclosure of Interests None declared